Project Harar: Research Update

Transforming Faces often works with partners in our project countries. In Ethiopia, we work alongside Project Harar, a community-based outreach charity that provides treatment for patients with cleft lip and palate living in rural villages across eastern Ethiopia.

Project Harar locates, informs and transports patients to Addis Ababa where they receive care from local Ethiopian teams. Patients are transported back to their village once they are discharged.

The research project undertaken by Project Harar was important because it provided insight into the impact of a single cleft lip surgery.

Some of 356 patients with a cleft lip and/or palate, who received surgical treatment at least 6 months previously, were former Transforming Faces patients. They were interviewed and examined in 21 rural health centres.

Research Highlights include:

89% of patients are from farming families

Before surgery, 95% of patients considered the cause of their cleft to be ‘God’s will’

95% of respondents answered that they were unhappy before their surgery

47% of participants said the main problem before surgery was “Verbal insults and quarrelling”

25% of participants answered that the most important change, if any, that occurred postoperatively was “Looking beautiful or handsome”

For patients, the main emerging theme was that changed appearances lead to a feeling of equality, which in turn enhanced social participation.

99% of patients reported a positive change after their cleft surgery or care

Only 44% of school-age students (7-20) attended school prior to surgery. The reason for non-attendance was feared or actual insults from classmates in 96% of cases, financial reasons in just 4%.

After surgery, 78% of school-age students (7-20) attended school.

School attendance doubled for girls from 31% to 72%.

The number of students attending school in this study almost doubled because of the increased self confidence and a decrease in bullying.

In 5 cleft lip cases, they were unable to purse the lips to blow air and maintain a fire, which prevented the patients from engaging in an important family and cultural activities

Patients often compared themselves to non-cleft members of society and reported that they felt inferior, especially in public places

75% of patients reported problems with eating and/or drinking before the operation, with ingested material entering the nose being a common complaint. This sometimes led to isolation and feelings of embarrassment.

33% reported a problem with their hearing before surgery, which remained unchanged postoperatively. This underlines the need for audiology and ENT services as a part of comprehensive care.

One third of children are now being seen before their fifth birthday. This is great news as it suggests that children are getting help earlier – which allows them to go to school and receive speech therapy.

It is our hope that speech therapy can be expanded in the country so that rural villages will have access to these services.

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Transforming Faces equips local teams to provide comprehensive cleft lip and palate care that is accessible for all. Together, we are building happier, healthier lives for children and families in Asia, Africa and the Americas.